Giant Cell Tumor of the Thoracic Spine Presenting as a Posterior Mediastinal Tumor with Benign Pulmonary Metastases: A Case Report

Abstract

Giant cell tumor (GCT) is a benign neoplasm that usually involves the metaphysis and epiphysis of long bones. Although the spine is the fourth leading location of GCT, most of these lesions occur in the sacrum, followed by the thoracic, cervical and lumbar vertebrae (1). GCT of bone is a benign, but potentially aggressive lesion that shows local recurrence and metastases. Metastatic lung disease rarely originates from a benign tumor, but this can occur from GCT of bone (2). The incidence of lung metastases from a histologically proven GCT has range from 1% to 9% (3). To the best of our knowledge, this is the first reported case of a thoracic spinal GCT that simulated a mediastinal mass, along with dispaying benign pulmonary metastases, in the medical literature. Here we present a case of a histologically proven thoracic spinal GCT that presented as a mediastinal tumor with pulmonary metastases. Case ReportA 29-years-old man was admitted to the hospital for evaluation of active pulmonary tuberculosis. He had been in close contact with a person who was recently diagnosed with active pulmonary tuberculosis. The patient had developed a mild cough and back pain, but there were no other respiratory symptoms. The physical examination and the results of the laboratory tests, including examination for acid-fast bacilli in sputum smears, were unremarkable. Chest radiography showed a huge soft-tissue mass in the right upper mediastinum (Fig. 1A). Moreover, several sharply marginated, round nodules were observed in both lungs (Fig. 1A). The up- Giant cell tumor of bone is a benign, but potentially aggressive lesion that can show local recurrence and metastases. We report here on a case of a 29-year-old man who presented with an incidentally found mediastinal mass. Chest radiography and computed tomography showed a huge mediastinal mass with bilateral pulmonary nodules and the diagnosis of giant cell tumor with benign pulmonary metastasis was confirmed. To the best of our knowledge, this is the first reported case of primary thoracic spinal giant cell tumor manifesting as a huge mediastinal mass with pulmonary metastases.

A Case of Broncho-Paraspinal Fistula Induced by Metallic Devices: Delayed Complication of Thoracic Spinal Surgery

“…Although benign histologically, the tumors have an aggressive tendency to locally invade and recur 2) . At the time of surgery, an extensive surgery using various devices was the best choice due to the aggressive nature of the tumor, and the neurosurgeon could not anticipate future complications such as destruction of the bronchus and the formation of broncho-paraspinal fistula seen in this case.…”

“…Giant cell tumors represent approximately 5% of all bone tumors and over 20% of all benign bone neoplasms 2) . Although benign histologically, the tumors have an aggressive tendency to locally invade and recur 2) .…”